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The Quarterly Journal of Nuclear Medicine 2000 December;44(4):325-32


lingua: Inglese

Dosimetry in radionuclide therapies with 90Y-conjugates: the IEO experience

Cremonesi M., Ferrari M., Chinol M., Bartolomei M., Stabin M. G., Fiorenza M., Tosi G., Paganelli G.

From the Departments of Medical Physics and Nuclear Medicine European Institute of Oncology (IEO), Milan, Italy *Department of Radiology and Radiological Sciences Vanderbilt University, Nashville, USA


The ­basis for a suc­cess­ful radio­nu­clide ther­a­py is a ­high and ­stable ­uptake of the radio­phar­ma­ceu­ti­cal in the tar­get tis­sue ­along ­with low activ­ity con­cen­tra­tion in oth­er nor­mal ­organs. The con­tri­bu­tion of dosim­e­try in radio­nu­clide ther­a­py is to pre­dict ­before the treat­ment the ­absorbed dos­es in ­tumor and nor­mal ­organs, to iden­ti­fy the crit­i­cal ­organs, to min­i­mize any pos­sible tox­ic­ity and to eval­u­ate the max­i­mum tol­er­at­ed ­dose. We ­report our expe­ri­ence con­cern­ing phar­ma­cok­i­net­ics and dosim­e­try of two 90Y-ther­a­peu­tic pro­to­cols: 3-­step pre­tar­get­ing radio­im­mu­no­ther­a­py (RIT) accord­ing to the bio­tin-avi­din ­system and recep­tor medi­at­ed radio­nu­clide ther­a­py ­with the som­a­tos­ta­tin ana­logue ­[DOTA-D-Phe1-Tyr3] octreotide named DOT­A­TOC. For the dos­i­met­ric anal­y­sis, anal­o­gous approach­es for the two radio­lab­eled com­pounds due to the sim­i­lar phar­ma­cok­i­net­ic char­ac­ter­is­tics ­were adopt­ed; the ­MIRD for­mal­ism was ­applied, tak­ing ­into ­account ­both the phys­i­cal and the bio­log­i­cal char­ac­ter­is­tics of the radio­con­ju­gate and ­patients’ metab­olism. In ­order to deter­mine bio­log­i­cal clear­ance, seri­al ­blood sam­ples and com­plete ­urine col­lec­tion ­were ­obtained up to 48 ­hours ­after injec­tion; to eval­u­ate bio­dis­trib­u­tion, sev­er­al ­whole ­body ­scans ­were ­acquired. Both ther­a­pies ­showed the advan­ta­geous char­ac­ter­is­tics of a ­fast ­blood clear­ance and a pre­dom­i­nant­ly ­renal excre­tion of the radio­phar­ma­ceu­ti­cals ­thus low­er­ing the irra­di­a­tion of the ­total ­body. Although phar­ma­cok­i­net­ic char­ac­ter­is­tis ­were sim­i­lar, dif­fer­ent crit­i­cal ­organs ­were ­found for the two ther­a­pies; in par­tic­u­lar, ­some con­sid­er­a­tions regard­ing red mar­row, ­spleen and kid­neys ­were ­required. The ­results of our stud­ies indi­cate ­that ­high activ­ities of 90Y-bio­tin (3-­step RIT) and 90Y-DOT­A­TOC can be admin­is­tered ­with accept­able radi­a­tion dos­es to nor­mal ­organs.

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